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Yim SH. Clinician bodies in eating disorder services: a commentary. Eat Disord 2024:1-9. [PMID: 38845209 DOI: 10.1080/10640266.2024.2358267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
This article discusses the important yet under-addressed issue of clinician bodies within eating disorder services. I would like to further the discussion on a particular correspondence in, where a professional who was perceived as dangerously thin was challenged and confronted by their colleagues in a work setting. This article will consider the issue from four perspectives, being the implications for the therapeutic relationship, how we approach biases and assumptions about weight and body size, ethical and legal issues, and how to manage lived experience. I argue for a more nuanced, considered approach towards professionals in the field before decisions are made to manage or confront them.
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Affiliation(s)
- See Heng Yim
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Bijkerk CAC, Nooteboom LAL, de Beer CBC, de Vos JAJA, Vermeiren RRJMR. Treating eating disorders by professionals with similar experiences: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2024. [PMID: 38762887 DOI: 10.1002/erv.3100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/19/2024] [Accepted: 04/26/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE Although a significant number of professionals who provide eating disorder (ED) treatment have lived experience with an ED in the past, there is no consensus on whether these professionals should use these experiences in treatment. This review aims to evaluate current literature on recovered professionals with an ED past treating ED patients, unravelling advantages and disadvantages in treatment, the impact on professionals and their surroundings, and implications for practice. METHOD A systematic literature search was conducted which included 10 articles. We analysed qualitative data through a systematic synthesis. Strength of evidence was calculated for each subtheme. RESULTS Three themes and 14 subthemes were divided into categories. The category 'treatment (patient-professional interaction)' was divided into: advantages, disadvantages and other implications for treatment. Additionally, the category 'professionals themselves' included subthemes that directly impact or relate to ED professionals: recovery as a non-linear process, the significant role of self-care and adverse feelings of professionals. Finally, the category 'work settings' included: company culture and training, supervision and professional development. DISCUSSION Recovered ED professionals are a promising addition to ED treatment due to the enhanced expertise of the professional. However, attention should be paid to the risk of distorted boundaries between patient and professional.
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Affiliation(s)
- C A Charlotte Bijkerk
- LUMC Curium - Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Human Concern - Centre for Eating Disorders, Amsterdam, The Netherlands
| | - L A Laura Nooteboom
- LUMC Curium - Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - C B Carolijn de Beer
- LUMC Curium - Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - J A Jan Alexander de Vos
- Department of Psychology (PHT), University of Twente, Enschede, The Netherlands
- GGZ Friesland, Leeuwarden, The Netherlands
| | - R R J M Robert Vermeiren
- LUMC Curium - Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Youz, Parnassia Psychiatric Institute, The Hague, The Netherlands
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3
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Garnett A, Ploeg J, Markle-Reid M, Strachan PH. Factors impacting the access and use of formal health and social services by caregivers of stroke survivors: an interpretive description study. BMC Health Serv Res 2022; 22:433. [PMID: 35365130 PMCID: PMC8975449 DOI: 10.1186/s12913-022-07804-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence has shown that family and friend caregivers of stroke survivors are significantly and negatively impacted by caregiving. The negative effects of caregiving may persist over time suggesting that caregivers might benefit from ongoing engagement with supportive services. However, little is known about caregivers' use of formally funded health and social services, or the factors influencing their access to and use of these services. The aim of this study is to increase understanding of the factors that influence stroke caregivers' access and use of formal health and social services, from the perspective of stroke caregivers and healthcare providers. METHODS A qualitative study was conducted with stroke caregivers and health providers in Ontario, Canada using interpretive description. In-depth interviews were conducted with caregivers of survivors who experienced a stroke between six months to five years previous and healthcare providers who support caregivers and stroke survivors. All participants provided written informed consent. Interview data were analyzed using constant comparison to identify codes and develop key thematic constructs. RESULTS A total of 40 interviews were conducted with 22 stroke caregivers at an average 30-months post-stroke and 18 health providers. Factors that influenced stroke caregivers' access and use of services included: finances and transportation; challenges caregivers faced in caring for their health; trust that they could leave their family member and trust in health providers; limited information pertaining to services and a lack of suitable services; and the response of their social networks to their caregiving situation. CONCLUSION Stroke caregivers experience significant challenges in accessing and using formal health and social services. These challenges could be addressed by increasing availability of subsidized community-based supports such as respite and counselling tailored to meet the ongoing needs of caregivers. Systemic change is needed by the health system that readily includes and supports caregivers throughout the stroke recovery continuum, particularly in the community setting.
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Affiliation(s)
- Anna Garnett
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada.
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, ON, Canada.,Aging, Community and Health Research Unit, McMaster University, Hamilton, ON, Canada.,McMaster University, 1280 Main St. W, Hamilton, ON, Canada
| | - Maureen Markle-Reid
- School of Nursing, McMaster University, Hamilton, ON, Canada.,Aging, Community and Health Research Unit, McMaster University, Hamilton, ON, Canada.,McMaster University, 1280 Main St. W, Hamilton, ON, Canada
| | - Patricia H Strachan
- School of Nursing, McMaster University, Hamilton, ON, Canada.,McMaster University, 1280 Main St. W, Hamilton, ON, Canada
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Bachner-Melman R, de Vos JA, Zohar AH, Shalom M, Mcgilley B, Oberlin K, Murray L, Lamarre A, Dooley-Hash S. Attitudes towards eating disorders clinicians with personal experience of an eating disorder. Eat Weight Disord 2021; 26:1881-1891. [PMID: 33044728 DOI: 10.1007/s40519-020-01044-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/01/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study explores the perspectives and opinions towards ED clinicians with lived experience of ED. METHODS Three hundred and eighty-five ED clinicians and 124 non-clinicians from 13 countries, between 18 and 76 years of age completed an online survey about attitudes towards ED clinicians with a personal ED history. Almost half the respondents (n = 242, 47.5%) reported a lifetime ED diagnosis. Survey items included ten multiple-choice and three open questions about clinician disclosure, employer hiring practices, and perceived advantages and disadvantages of clinicians with a personal ED history practicing in the ED field. Multiple-choice responses from clinicians with and without a personal ED history were compared with responses from non-clinicians with and without a personal ED history. Open questions were examined using thematic analysis. RESULTS Clinicians with no ED history, whose responses often differed from both ED-history groups (clinicians and non-clinicians), were more likely to indicate that clinicians with an ED should not generally treat ED patients, and that clinicians should self-disclose their ED history to employers but not to their patients. Thematic analysis of the open-ended questions revealed that advantages of having clinicians with an ED history include a deep experiential understanding and the ability to be empathic and non-judgmental, whereas disadvantages include the lack of objectivity and the risk of clinicians being triggered. CONCLUSION Further research informing guidelines for ED clinicians with a personal ED history, their colleagues and employers are needed to protect and empower the significant minority of ED professionals with "lived experience" of EDs. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Rachel Bachner-Melman
- Ruppin Academic Center (Clinical Psychology Graduate Program), Emek Hefer, Israel. .,Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Jan Alexander de Vos
- Stichting Human Concern, Centre for eHealth and Well-Being Research, Centrum voor eetstoornissen, Twente University, Enschede, Netherlands
| | - Ada H Zohar
- Ruppin Academic Center (Clinical Psychology Graduate Program), Emek Hefer, Israel
| | - Michal Shalom
- Ruppin Academic Center (Clinical Psychology Graduate Program), Emek Hefer, Israel
| | - Beth Mcgilley
- Department of Psychiatry, School of Medicine, University of Kansas, Lawrence, KS, USA
| | - Kielty Oberlin
- Trinity College Dublin's Schools of Psychology and Nursing, Dublin 2, Ireland
| | - Leslie Murray
- Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | | | - Suzanne Dooley-Hash
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
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King AJ, Brophy LM, Fortune TL, Byrne L. Factors Affecting Mental Health Professionals' Sharing of Their Lived Experience in the Workplace: A Scoping Review. Psychiatr Serv 2020; 71:1047-1064. [PMID: 32878543 DOI: 10.1176/appi.ps.201900606] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Research has suggested that some mental health professionals (MHPs) continue to hold stigmatized beliefs about persons with emotional distress. These beliefs may be amenable to contact-based interventions with similar peers. To inform future interventions, policy, and research, this scoping review examined existing literature to identify factors that affect disclosure of lived experience by MHPs to colleagues and supervisors. METHODS A systematic search was conducted of four online databases, gray literature, and the reference lists of included articles. Primary research studies of any design conducted with MHPs with lived experience of emotional distress and their colleagues were included. The findings of included studies were inductively coded within the themes of enabling, constraining, and intrapersonal factors influencing disclosure. RESULTS A total of 23 studies were included in data extraction and synthesis. Factors that influenced MHPs' sharing of their lived experience in the workplace were categorized into five overarching themes: the "impaired professional," the "us and them" divide, the "wounded healer," belief in the continuum of emotional distress, and negotiating hybrid identities. MHPs with lived experience described feeling conflict between professional and service user identities that affected the integration and use of their clinical and experiential knowledge. Enabling factors reflected best-practice human resource management, such as organizational leadership, access to supervision and training, inclusive recruitment practices, and the provision of reasonable accommodations. CONCLUSIONS Findings of this scoping review suggest that organizational interventions to support MHPs in order to share their lived experience may improve workplace diversity and well-being, with implications for service users' experience.
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Affiliation(s)
- Alicia J King
- Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Melbourne (King, Brophy, Fortune); Melbourne School of Population and Global Health, University of Melbourne, Melbourne (Brophy); School of Management, RMIT University, Melbourne, and Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Byrne)
| | - Lisa M Brophy
- Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Melbourne (King, Brophy, Fortune); Melbourne School of Population and Global Health, University of Melbourne, Melbourne (Brophy); School of Management, RMIT University, Melbourne, and Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Byrne)
| | - Tracy L Fortune
- Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Melbourne (King, Brophy, Fortune); Melbourne School of Population and Global Health, University of Melbourne, Melbourne (Brophy); School of Management, RMIT University, Melbourne, and Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Byrne)
| | - Louise Byrne
- Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Melbourne (King, Brophy, Fortune); Melbourne School of Population and Global Health, University of Melbourne, Melbourne (Brophy); School of Management, RMIT University, Melbourne, and Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Byrne)
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Graham MR, Tierney S, Chisholm A, Fox JRE. The lived experience of working with people with eating disorders: A meta-ethnography. Int J Eat Disord 2020; 53:422-441. [PMID: 31904870 DOI: 10.1002/eat.23215] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Working with people with eating disorders (EDs) is known to elicit strong emotional reactions, and the therapeutic alliance has been shown to affect outcomes with this clinical population. As a consequence, it is important to understand healthcare professionals' (HCPs') experiences of working with this client group. METHOD A meta-synthesis was conducted of qualitative research on HCPs' lived experiences of working with people with EDs. The results from the identified studies were analyzed using Noblit and Hare's meta-ethnographic method. Data were synthesized using reciprocal translation, and a line of argument was developed. RESULTS Thirty-seven studies met the inclusion criteria. Reciprocal translation resulted in a key concept: "Coping with caring without curing." This was underpinned by the following third-order concepts: (a) "The dissonance and discomfort of being a helper struggling to help," (b) "Defending against the dissonance," and (c) "Accepting the dissonance to provide safe and compassionate care." These concepts were used to develop a line-of-argument synthesis, which was expressed as a new model for understanding HCPs' experiences of working with people who have an ED. DISCUSSION Although the conflict associated with being a helper struggling to help led some HCPs to avoid and blame people with EDs, others adopted a compassionate stance characterized by humanity, humility, balance, and awareness.
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Affiliation(s)
- Meghan R Graham
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amy Chisholm
- Vincent Square Eating Disorder Service, Central and North West London NHS Foundation Trust, London, UK
| | - John R E Fox
- South Wales Doctoral Programme in Clinical Psychology, School of Psychology, Cardiff University, Cardiff, UK
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Moller N, Tischner I. Young people’s perceptions of fat counsellors: “How can THAT help me?”. QUALITATIVE RESEARCH IN PSYCHOLOGY 2019. [DOI: 10.1080/14780887.2018.1536384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Naomi Moller
- The Open University, School of Psychology, United Kingdom
| | - Irmgard Tischner
- Technische Hochschule Deggendorf (THD), Applied Healthcare Sciences, Germany
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